Dr Andrew Gunn

Supporting Information

It's tough losing a war of conquest. The historical record confirms that, in all times and places, defeated peoples whose land is seized do badly.

History gets written, and sometimes totally sanitised, by the victors.Despite this, Aboriginal health statistics--for instance a two-decade deficit in life expectancy--provide an objective and persistent reminder that something is very wrong.

I have many Aboriginal patients, and it's been pleasing to hear good rhetoric on Aboriginal health from the newly-elected president of the Australian Medical Association. Admittedly, the good rhetoric isn't surprising. Medical organisations tend to have good policies on anything--even if that occasionally seems close to nothing--that doesn't conflict with the more self-centred concerns of their members.

Status is central to human communities. And, although contemporary societies might feature more upward and downward mobility than traditional ones, we still meander through life within boundaries largely determined before birth; and, all the time, we compare ourselves with others--both within and outside our community.

This is highly relevant to health. There's compelling research evidence that it's good for your health to feel in control of your life and to feel that you are respected. Many studies show that lower social status is associated with lower life expectancy, and that's independent of risk factors like obesity and smoking. The greater the social disparity, the greater this effect.

Perhaps as a result, many people tend towards chronic insecurity. Not only are human pecking orders stressful, particularly if they're grossly inegalitarian, but we live on a planet whose apex predator is a rapacious carnivore that's easily moved to extreme violence. Who wouldn't get nervous about that?

With this in mind, I have a question. Please treat it as a call to cognition, not a call to confrontation.

Would Aborigines feel better about themselves, and therefore have better health today, if their forebears had been more successful fighting Europeans?

Consider Aboriginal pride in Pemulwuy. He was a warrior of the Eora people, one-time owners of prime Sydney real estate--about 1800 square kilometres of it. Unfortunately, trespassers moved in and the neighbourhood got rough. Tit-for-tat slayings, or most likely an unequal struggle of several tits per tat, went on for years.

The bringers of civilisation to this dark land eventually killed him.The stroppy native's head was severed and dispatched to the motherland in spirits, presumably because the English lacked the skill to shrink it.

And, of course, over the next century or so, the invaders replicated similar victories over the locals right across the continent. Indigenous Australians--badly out-gunned and often out-numbered--lost the lot.

Tragically, many also lost the plot.

A human community's pride and spirit rests on many things. Sadly, these include fighting effectively. It is hugely dispiriting to be easily defeated by invading forces.

Another source of pride is tool making, and this continent's inhabitants paid dearly for their millennia of isolation. Woomeras and boomerangs remain brilliant innovations but the guns and metal of the invaders must surely have severely shaken the locals' confidence in their abilities.

But, as previously noted, I'm not making a call to arms. That's an ugly horse to back and, anyway, it bolted a couple of centuries ago.

Mahatma Gandhi, who admittedly had numbers on his side, demonstrated that there are more elegant ways to accrue power. The gains made by Aboriginal people--for instance recognition in the 1967 referendum and certain land rights--have not been through violence but through endurance and appeals to the rationality of powerful whites.

Unfortunately, rationality is not a strong point of our nation's current leaders. The chances of significantly improving Aboriginal health are remote when many politicians are, in my opinion, too intellectually and morally bankrupt to even admit the blindingly obvious--no community willingly gives away its land and homes.

The pitifully inadequate funding of indigenous health programs needs to be fixed but this underfunding is just a symptom of the cause of poor Aboriginal health. A recent study in Arnhem Land pointed towards the underlying cause, when it demonstrated that Aboriginal communities that are connected with, and care for, their ancestral homelands have better health.

Indigenous Australians need to be accorded, and treated with, a respect that has been sadly lacking. Severely fractured human relationships can take years to repair but simply saying "sorry" is always a nice way to start.